Abstract：
UNASSIGNED: To compare procedural and long-term costs associated with the use of Balloon-Expandable Covered Stents (BECS) in the management of Aortoiliac Occlusive Disease (AIOD).
UNASSIGNED: A cost-consequence model was developed to simulate the intra- and post-operative management of patients with AIOD from the perspective of private health-payers. The study assessed the costs of the LifeStream (BD, Franklin Lakes, New Jersey), iCAST/Advanta V12 (Getinge, Goteborg, Sweden), BeGraft Peripheral (Bentley, Hechingen, Germany), and Viabahn Balloon Expandable (VBX) (W.L. Gore, Flagstaff, Arizona) BECS devices. Device costs were identified from the Australian Prosthesis List, whereas clinical outcomes of BECS were estimated from a systematic review of the literature. Costs were calculated over 24 and 36 month time horizons and reported in US dollars.
UNASSIGNED: Long-term, per-patient cost of each device at 24 and 36 months was $6253/$6634 for the LifeStream; $6359/$6869 for the iCAST/Advanta V12; $4806 (data available to 24 months) for the BeGraft Peripheral; and $4839/$5046 for the Viabahn VBX, respectively. Most of the cost difference was attributed to the number of stents required per treated limb and frequency of clinically-driven target lesion revascularization events.
UNASSIGNED: Best-available clinical evidence and economic modeling demonstrates that the BeGraft Peripheral and Viabahn VBX were of similar cost and the least costly options at 24 months, whereas at 36 months, the lowest cost BECS option for the treatment of AIOD was the Viabahn VBX.
CONCLUSIONS: This analysis supports economically informed decision-making for health-payers managing systems that care for patients with AIOD. Stent length and avoiding reintervention were identified as key areas of cost-saving for future BECS development.
UNASSIGNED: A cost-consequence model was developed to simulate the intra- and post-operative management of patients with AIOD from the perspective of private health-payers. The study assessed the costs of the LifeStream (BD, Franklin Lakes, New Jersey), iCAST/Advanta V12 (Getinge, Goteborg, Sweden), BeGraft Peripheral (Bentley, Hechingen, Germany), and Viabahn Balloon Expandable (VBX) (W.L. Gore, Flagstaff, Arizona) BECS devices. Device costs were identified from the Australian Prosthesis List, whereas clinical outcomes of BECS were estimated from a systematic review of the literature. Costs were calculated over 24 and 36 month time horizons and reported in US dollars.
UNASSIGNED: Long-term, per-patient cost of each device at 24 and 36 months was $6253/$6634 for the LifeStream; $6359/$6869 for the iCAST/Advanta V12; $4806 (data available to 24 months) for the BeGraft Peripheral; and $4839/$5046 for the Viabahn VBX, respectively. Most of the cost difference was attributed to the number of stents required per treated limb and frequency of clinically-driven target lesion revascularization events.
UNASSIGNED: Best-available clinical evidence and economic modeling demonstrates that the BeGraft Peripheral and Viabahn VBX were of similar cost and the least costly options at 24 months, whereas at 36 months, the lowest cost BECS option for the treatment of AIOD was the Viabahn VBX.
CONCLUSIONS: This analysis supports economically informed decision-making for health-payers managing systems that care for patients with AIOD. Stent length and avoiding reintervention were identified as key areas of cost-saving for future BECS development.
摘要：
■比较与在主动脉闭塞性疾病（AIOD）的管理中使用球囊可扩张覆膜支架（BECS）相关的程序和长期成本。
■开发了一种成本-后果模型，以从私人健康支付者的角度模拟AIOD患者的术中和术后管理。这项研究评估了生活流的成本(BD，富兰克林湖,新泽西州），iCAST/AdvantaV12(Getinge,哥德堡,瑞典),Begraft外围设备(Bentley,赫辛根,德国),和Viabahn气球可扩展（VBX）（W.L.Gore，弗拉格斯塔夫,亚利桑那州）BECS设备。设备成本从澳大利亚假体清单中确定，而BECS的临床结局是通过对文献的系统回顾来估计的。成本是在24和36个月的时间范围内计算的，并以美元报告。
■长期，LifeStream在24个月和36个月时，每个设备的每位患者费用为$6253/$6634；iCAST/AdvantaV12为$6359/$6869；Begraft外围设备为$4806（24个月可用数据）；ViabahnVBX为$4839/$5046，分别。大部分成本差异归因于每个治疗肢体所需的支架数量和临床驱动的靶病变血运重建事件的频率。
■现有的最佳临床证据和经济模型表明，在24个月时，BegraftPeripheral和ViabahnVBX的成本相似，成本最低。而在36个月时，治疗AIOD的成本最低的BECS选择是ViabahnVBX。
结论：本分析支持对AIOD患者的健康支付者管理系统进行经济知情决策。支架长度和避免再干预被确定为未来BECS开发成本节约的关键领域。
■开发了一种成本-后果模型，以从私人健康支付者的角度模拟AIOD患者的术中和术后管理。这项研究评估了生活流的成本(BD，富兰克林湖,新泽西州），iCAST/AdvantaV12(Getinge,哥德堡,瑞典),Begraft外围设备(Bentley,赫辛根,德国),和Viabahn气球可扩展（VBX）（W.L.Gore，弗拉格斯塔夫,亚利桑那州）BECS设备。设备成本从澳大利亚假体清单中确定，而BECS的临床结局是通过对文献的系统回顾来估计的。成本是在24和36个月的时间范围内计算的，并以美元报告。
■长期，LifeStream在24个月和36个月时，每个设备的每位患者费用为$6253/$6634；iCAST/AdvantaV12为$6359/$6869；Begraft外围设备为$4806（24个月可用数据）；ViabahnVBX为$4839/$5046，分别。大部分成本差异归因于每个治疗肢体所需的支架数量和临床驱动的靶病变血运重建事件的频率。
■现有的最佳临床证据和经济模型表明，在24个月时，BegraftPeripheral和ViabahnVBX的成本相似，成本最低。而在36个月时，治疗AIOD的成本最低的BECS选择是ViabahnVBX。
结论：本分析支持对AIOD患者的健康支付者管理系统进行经济知情决策。支架长度和避免再干预被确定为未来BECS开发成本节约的关键领域。
